腎機能評価におけるα1-microglobulinの意義 CDDP使用例の検討―

Abstract

血清および尿中のα1-MGは各々腎の糸球体機能, 尿細管機能の指標と同様有用である.CDDP投与後の尿細管障害の程度を診断するために尿中α1-MGを他の指標パラメーターとともに測定することは不可逆的な腎障害を防止する意味で有用と考えれる

To evaluate the clinical usefulness of alpha 1-microglobulin (alpha 1-MG) as parameter of renal function, we determined the levels of alpha 1-MG in the serum and urine of patients who had no malignant tumors, and compared them with the levels of beta 2-microglobulin (beta 2-MG), serum creatinine, urinary N-acetyl-beta-glucosaminidase (NAG) and 24-hour creatinine clearance (24 Ccr). There were significant positive correlations between alpha 1-MG in the serum and urine, and those of beta 2-MG levels. Serum alpha 1-MG and 24 Ccr were inversely correlated. Combined measurements of alpha 1-MG in the serum and urine seemed to be useful to estimate glomerular and tubular renal functions. The renal function in 8 patients with advanced urogenital cancers treated with cis-diammine-dichloroplatinum (CDDP) was examined by measuring 24 Ccr, alpha 1-MG, and beta 2-MG in serum and urine and urinary NAG. Determination of urinary alpha 1-MG was useful for early detection of tubular damage after CDDP administration.